NEW YORK (Reuters Health) - Obese women, particularly white
obese women, are less likely than their thinner peers to be
screened for breast and cervical cancers, researchers reported
Monday.

In a review of 32 previously published studies, researchers
found that obesity was consistently linked to lower rates of
breast and cervical cancer screening among white women.
Fourteen studies focused on cervical cancer, 10 on breast
cancer and 8 looked at colorectal cancer.

Sarah S. Cohen and colleagues at the University of North
Carolina, Chapel Hill, report the findings in the online
edition of the journal Cancer.

The National Cancer Institute recommends that women have a
mammogram to detect breast cancer every one to two years,
starting at age 40, and a Pap test to screen for cervical
cancer at least once every three years, beginning about three
years after they start having sex.

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It's not certain why obese women are less likely to get
these screening tests, as few studies have been designed to
look at the underlying reasons, according to Cohen and her
colleagues.

However, they point out, some research shows that obese
women often worry about embarrassment in the exam room,
negative reactions from healthcare providers and "lectures"
about their weight.

One of the studies in the review also found that obese
women often complained that the gowns, exam tables and
equipment at doctors'

offices were too small for them.

Another possibility, according to Cohen's team, is that
doctors less often recommend cancer screening to obese women
than to thinner women. But there was a lack of evidence
supporting this in the studies reviewed. One study found that
obese women were more likely to say their doctor had advised
them to get a Pap test.

In contrast to the case with breast and ovarian cancer
screening, Cohen's team found no consistent evidence that
obesity lowered the odds of colon cancer screening.

About half of the studies on colon cancer screening found
lower screening rates among obese women, while the rest did
not.

The findings suggest that more should be done to encourage
obese women, particularly obese white women, to get regular
mammograms and Pap tests, according to Cohen and her
colleagues.

With colon cancer screening, however, the number of women
who follow recommended testing is too low across the board, the
researchers point out.

This, they write, means that "outreach to all women should
remain the objective for colorectal cancer screening programs."